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Breastfeeding and Marijuana: What You Need to Know Now

Marijuana plant

Now that marijuana is legalized in several US states, parents often assume that it’s safe to use marijuana while breastfeeding or during pregnancy. But before you use it, here are facts you need to know about marijuana while breastfeeding.

Get the terms straight

The Cannabaceae family of plants includes the cannabis plant. A cannabis plant contains more than eighty biologically active chemical compounds.

From a healthcare perspective, the two compounds that are especially important are:

  • tetrahydrocannabinol (THC)
  • cannabidiol (CBD)

There are a variety of types of cannabis plants. One of which is marijuana. Marijuana contains THC, which produces a mental “high.”

Another type of cannabis plant is hemp. As you might expect, this cousin of the marijuana plant also contains both THC and CBD. But, hemp contains a very low level of THC.

While, marijuana and hemp are both in the same plant family contain THC and CBD, the amounts in each make their effects very different.

And, we can consume chemical compounds THC or CBD without consuming the actual cannabis plant. Here, I’ll be focusing on THC, but stay tuned for a post on CBD.

Hence, although the THC is the concern for breastfeeding infants, it’s often easier to address the fact that it’s in the product people are using: marijuana.

Marijuana has a therapeutic effect

Studies show that cannabinoids can be useful for medicinal purposes in certain instances, including nausea and neuropathic pain. There are also several marijuana-based medications on the market. 

Why marijuana while breastfeeding and pregnancy is dangerous

THC has a very long half-life. (Half-life is the number of hours or days it takes for half of the substance to be eliminated from the body.) Using marijuana while breastfeeding is problematic because THC passes through the mother’s milk and can remain in the milk for up to six days after use, and it can remain in the baby’s system even longer.

Most sources agree that THC may affect a newborn’s brain development and can result in hyperactivity, poor cognitive function, and other long-term consequences.

A review article summarized several studies showing that infants with THC in their systems exhibit sedation, growth delay, poor muscle tones, and poor sucking. Further, that same article explained some relationships between marijuana and hormones that regulate appetite, too.

The Food and Drug Administration’s position

In a statement issued October 16, 2019, the FDA states:  “There are many potential negative health effects from using marijuana and other products containing THC during pregnancy and while breastfeeding.”

Bottom line, the FDA issues a strong warning against using chemical components of products such as marijuana while breastfeeding and pregnancy.

Centers for Disease Control and Prevention’s position

The CDC points out multiple studies showing that marijuana use during pregnancy has been linked to increasing the baby’s risk for developmental problems.

The CDC acknowledges that THC is stored in fat and remains in milk for a period of time. But, they state that “data on the effects of marijuana exposure to the infant through breastfeeding are limited and conflicting.”

In my view, the CDC’s directive on using marijuana while breastfeeding has more of a “better safe than sorry” flavor. Citing multiple studies, they conclude that to “limit potential risk to the infant, breastfeeding mothers should reduce or avoid marijuana use.”

Surgeon General’s position

The Surgeon General gives words of warning about using marijuana while breastfeeding or during pregnancy that are similar to those in other government documents. And, the Surgeon General reminds us of another factor that is sometimes overlooked: Marijuana smoke contains many of the same harmful components as tobacco smoke.

The American College of Obstetricians and Gynecologists’s position

ACOG cannot condone the use of marijuana during pregnancy, including the use of medicinal marijuana. And, ACOG states: “There are insufficient data to evaluate the effects of marijuana use on infants during lactation and breastfeeding, and in the absence of such data, marijuana use is discouraged.”

The American Academy of Pediatrics’ position

An AAP clinical report recommends that “pediatricians advise adolescents and women of childbearing age to abstain from marijuana use while pregnant or breastfeeding due to potential adverse consequences to the fetus, infant or child.”

The AAP holds that while there is little data about the impact of  marijuana while breastfeeding, there are serious concerns about the exposure to smoke.

The Academy of Breastfeeding Medicine’s position

The ABM states that mothers should eliminate or reduce their use of marijuana while breastfeeding to avoid exposing infants. Note, however, that the ABM’s fairly lengthy protocol gives little practical guidance to those on the front lines of perinatal clinical care. 

We don’t have all of the information

Maybe some of you assumed that the facts were all here and that THC use is completely contraindicated during breastfeeding. Others were perhaps hoping that the public health authorities had lightened up, and given a green light. But that’s not the case. The questions surrounding marijuana while breastfeeding have complicated answers.

Finally, in the case of almost all substances — prescription, non-prescription, herbal, environmental, legal or illegal — the question is about risk benefit. The risk/benefit to the infant of consuming the mother’s milk versus the consuming the THC is unclear in some or many situations. Note that in my interview with Dr. Isabel Basaldu-Prado, a neonatologist who developed a protocol at her own hospital, she insists that the benefits of human milk cannot be overlooked, and there are multiple factors to be considered. I’ve also written on ways to eliminate or reduce risk from drugs.

Bottom line

While we don’t have all of the information, marijuana while breastfeeding or pregnant may have a variety of adverse effects on the infant. The major health organizations advise for mothers to discontinue or reduce their usage of marijuana while breastfeeding and during pregnancy.

Have you reduced or eliminated your use of marijuana while breastfeeding? Tell me your experiences in the comments section below!

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